Solving the dilemma of the immunohistochemical and other methods used for scoring estrogen receptor and progesterone receptor in patients with invasive breast carcinoma

BACKGROUND: The authors attempted to resolve the dilemma posed by the lack of unanimity concerning the optimal immunohistochemical (IHC) method for determining and scoring estrogen receptor (ER) and progesterone receptor (PR). METHODS: Sections for IHC were prepared from paraffin embedded tumor samples from 402 patients with lymph node positive breast carcinoma who had biochemical receptor values (obtained with the dextran-coated charcoal [DCC] method) and who were enrolled in a prospective, randomized trial (National Surgical Adjuvant Breast and Bowel Project protocol B-09). IHC receptors were scored independently by two observers according to percent, intensity, and any-or-none algorithms. Results from these evaluations and from two computer-assisted evaluations, DCC, and common pathologic characteristics were analyzed for optimum splits for positive reactions in univariate and multivariate analyses using a tree-structured model. Concordance, sensitivity, and specificity were determined between the DCC method and all other methods. RESULTS: Interobserver agreement and concordance between the DCC method and the other methods and among the methods were high. Univariate analyses revealed that a positive ER score obtained with all methods was related significantly to overall survival (OS) at 5 years and at 10 years. Results related to PR scores and disease-free survival and recurrence-free survival were less consistent. In multivariate analysis, it also was found that all methods for scoring ER predicted a better prognosis for OS in patients with an unfavorable lymph node status at 5 years and 10 years. Patients in a favorable lymph node status group were discriminated further by nuclear grade. CONCLUSIONS: All IHC methods for scoring ER appeared valid as prognostic indicators of OS in patients with positive lymph nodes. The any-or-none IHC method, by virtue of its simplicity, represents an appropriate choice for practical use.     

Studies of the anticancer potential of plants used in Bangladeshi folk medicine

The present study evaluated the anticancer potential of 11 plants used in Bangladeshi folk medicine. The extracts were tested for cytotoxicity using the brine shrimp lethality assay, sea urchin eggs assay, hemolysis assay and MTT assay using tumor cell lines. The extract of Oroxylum indicum showed the highest toxicity on all tumor cell lines tested, with an IC(50) of 19.6 microg/ml for CEM, 14.2 microg/ml for HL-60, 17.2 microg/ml for B-16 and 32.5 microg/ml for HCT-8. On the sea urchin eggs, it inhibited the progression of cell cycle since the frist cleavage (IC(50)=13.5 microg/ml). The extract of Aegle marmelos exhibited toxicity on all used assays, but in a lower potency than Oroxylum indicum. In conclusion, among all tested extracts, only the extracts of Oroxylum indicum, Moringa oleifera and Aegles marmelos could be considered as potential sources of anticancer compounds. Further studies are necessary for chemical characterization of the active principles and more extensive biological evaluations.     

Hair dye use and risk of lymphoid neoplasms and soft tissue sarcomas

We analyzed the relation between hair dye use and the risk of Hodgkin's disease (HD), non-Hodgkin's lymphoma (NHL), multiple myeloma (MM) and soft tissue sarcomas (STS) in a hospital-based case-control study conducted between 1985 and 1997 in northern Italy. Cases included 158 patients with histologically confirmed incident HD, 446 with NHL, 141 with MM, 221 with STS and controls included 1,295 patients with acute nonneoplastic conditions. Compared to never use of any type of hair dyes, the odds ratio (OR) for ever use was 0.68 (95% confidence interval, CI, 0.40-1.18) for HD, 1.03 (95% CI 0.73-1.44) for NHL, 1.17 (95% CI 0.70-1.97) for MM and 0.73 (95% CI 0.45-1.17) for STS. The OR were close to unity for permanent and semipermanent dyes analyzed separately or when the analysis was restricted to women. Our study indicates that there is no appreciable association between ever use of any type of hair dyes and the risk of HD, NHL, MM or STS.     

Oral candidiasis treatment with Brazilian ethanol propolis extract

The Brazilian commercial ethanol propolis extract, also formulated to ensure physical and chemical stability, was found to inhibit oral candidiasis in 12 denture-bearing patients with prosthesis stomatitis candidiasis association.     

Patients in group psychotherapy

This study examines the patient in group psychotherapy, describing factors that provide changes during the process and the particularities of this therapeutic mode. Based on the available literature and the authors' systematic experience throughout thirty years of group therapeutic work, the variables that determine the commitment of the group members in a productive and well-succeeded therapeutic relation are discussed. It is emphasized how the patients assimilate the psychotherapeutic process and the way in which they participate in achieving their own improvement.     

Home Care--configurating the care model and joining different interests/needs in the care sector

This study aims to analyze a private Home Care service from the perspective of the formation of the Care Model. Focus groups and semistructured interviews were chosen as instruments for data collection. Interviews were held among middle-level nursing workers and service coordinators. Empiric data were organized by means of the Collective Subject Discourse methodology. It was disclosed that the recognition of the constituent elements of the care model among the social agents involved in the project is essential to negotiate, unite and instrumentalize the possibility to attend different interests. Another factor that stood out was the power of Home Care to be a tool for reviewing the health/illness/care process concept and, thus, for promoting the incorporation of values that lead to behavioral changes, moving towards a care model that is committed to the establishment of a welcoming relation, characterized by commitment and responsibility for the health of clients.     

The daily life of nurses in the Brazilian expeditionary force in the theater of operations during World War II, in Italy (1942-1945)

This historic-sociological study aims to analyze the daily challenges faced by army nurses in the Theater of Operations during the Second World War in Italy. The primary sources of investigation consist of three photographs taken during that period as well as testimonies by nine nurses, while literature on the subject is used as a secondary source. The discussion is supported by Pierre Bourdieu's concepts. The results show that these nurses faced the challenges of daily life at war and managed to adapt themselves to the adversities of the camping sites and wards. We infer that their daily life in this scenario not only made them overcome barriers, but also provided them with an opportunity to get to know new cultures and technologies.